Real World Clinical Blog: Troubled Me, Troubled You

Stress Level

There are times in our work, too many to count, when we get into trouble in our personal lives. Sometimes the trouble is of our own making. Sometimes things just happen to us. Perhaps we overdraw our checking account or our mom is sick in the hospital. It is impossible to avoid these swamplands. The question is always: how can we stay professionally afloat during them? I wonder about this often, but usually when it is too late and I am merely grasping for air.

A few years ago, I was in a horrible housing predicament, having sold our house before securing a mortgage for a new one. In between sessions, I was leaping toward the phone for updates, obsessed with finding security for my small family. When there was no message or update, I would wonder how I would survive the next 45-minute hour without checking my email every five minutes, if not more. I would sit in session fantasizing about taking my phone and throwing it against the wall and hearing the glass of the iPhone screen shatter. I have no idea why that was my wish. But I couldn’t stop imagining it.

Self-care, of course, is always suggested. It can sometimes help us preventatively or as an intervention. But when our internal resources are drained, it is particularly hard to find ways to take good care of ourselves. In fact, I find that it is when I am doing my best that I can be most creative with self care. During my lows, I can find no way toward it.

I have no clear answers on how to help during these times of trouble, but I will do my best. First, what can feel most crazy-making, while simultaneously practicing and suffering, is the way in which our struggles are made invisible by our clients’ naiveté about them. Of course, our clients shouldn’t know about our complex personal lives, but that doesn’t mean that being unseen feels good. This is why it is essential to have some people in your life who know about what is going on with you. If it is your supervisor, close friend, or partner, sharing your suffering keeps your work healthy and boundaried.

This invisibility is often made worse by our own refusal to admit when we are having a hard time. Although there is no clear binary between when things in our life are fine versus when they are not, there are definitive times when we know we are swimming upstream. It is of terrific import to name these times to ourselves. We need to own them and claim them for what they are -- an unavoidable aspect of our own humanity. To live in the world honestly is to suffer in it. There is no shame in that. Just because we are social workers does not mean that we have all our stuff figured out. The more we pressure ourselves to feel like we are “okay,” the more our suffering takes a toll on our overall wellness.

Pragmatically, there are ways to honor our own struggles. It makes sense to create space between clients. If you are used to seeing clients back-to-back with only 10 or 15 minutes in between, adding just five or 10 minutes to this can shift your ability to recalibrate in dramatic ways. Often, when we think about self care, it feels like an impossible endeavor. However, small shifts that allow us to check Facebook or Instagram, or call our moms, can return us back to our psychological base.

Beyond the ideal of self care is the inarguable need for attending to our basic human needs. There is no time when this is easier to abandon than when we are suffering. Attending to our basic needs actually takes incredible energy and determination. If we don’t eat a regular amount, breathe some fresh air, and sleep for around eight hours a night, we are causing ourselves tremendous strife. Furthermore, we are unable to really serve our clients. It is okay to be distracted, tired, angry, anxious. It is not okay to work when you are hungry and debilitatingly exhausted. While this is obvious, I know, it is also a subtle reminder that while self care can feel like a luxury, attending to our bodies' most basic standards is a necessity that renders our work possible.

I have come to strongly believe in the healing power of one daily practice. I am not referring to something complex, expensive, or inconvenient. I am talking about making an inarguable pact with yourself to do one consistent thing daily. Part of the reason I suggest it is because when this daily practice is something you can’t attend to, you can have a way of recognizing how much you are struggling. Think of the daily practice as a thermometer of your wellness that goes off when the daily practice cannot be properly honored.

Finally, while our own struggling depletes us, it can also lend tremendous depth and texture to our work. The goal is not to hide our pain, but to recognize the way that it can serve as clinical connective tissue. This is a way of thinking about use of self. By speaking from the place that knows pain, uncertainty, and suffering, we are able to help transform this in our clients. I am not describing a revealing of content, but a shared affective experience that often lends balm to the lonely wounds inflicted by anguish, fear, and chaos.

Danna R. Bodenheimer, LCSW, is in private practice at Walnut Psychotherapy Center in Philadelphia, PA, and teaches at Bryn Mawr College Graduate School of Social Work and Social Research. She provides more of her clinical perspective and tips for developing clinicians in her book, Real World Clinical Social Work: Find Your Voice and Find Your Way.